Memo to: Executive Directors Constituent Medical Associations From: James L. Madara, MD Date: February 3, 2021 Subject: 2021 Constituent Society Delegate Apportionment I am pleased to provide delegate apportionment figures for 2021. Last year our American Medical Association (AMA) again experienced membership growth, but the House of Delegates will be approximately the same size as it was in 2020. The 54 states and territories in the House of Delegates will be apportioned 306 delegates. I should note at the outset that the data used to apportion delegates are not comparable to our AMA’s official membership figures. You will recall that delegate apportionment from 2020 through 2022 includes pending members, and while the number of such members at the end of 2019 grew the House considerably, the numbers at the end of 2020 did not, thus leaving the House of Delegates at more or less the same size it was last year. Delegate apportionment for 2021 is based on official AMA membership records as of December 31, 2020. Those records include both members and pending members, individuals who are not members at the time they pay their dues to become members in the following year. Apportionment includes members who joined during calendar year 2020 (this would include renewing members), pending members for 2021, and those pending members from late-2019 who had renewed their memberships in the Association for 2021. This comports with Bylaw 2.1.1.1, which states, “The December 31 count will include pending members for purposes of apportionment; however, pending members shall not be recounted the following year absent membership renewal.” Stated differently, one must be a pending member in consecutive years to be counted for apportionment purposes. Bylaws 2.1.1.2.1 and 2.1.1.2.1.1 also affected this year’s apportionment. The former determines Pennsylvania’s apportionment given its membership losses from 2019, and the latter—the “freeze” adopted at November’s meeting—proved to benefit Alabama, Arkansas, California, Colorado, District of Columbia, Florida, Hawaii, Illinois, Kansas, Massachusetts, Michigan, Minnesota, Missouri, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, South Dakota, Virginia, and Washington. The counting of pending members affected most of these states. One delegate is apportioned for every 1,000, or fraction thereof, AMA members and eligible pending members. The attached table provides a state-by-state breakdown. Pending members who do not renew their memberships in 2021 (for 2022) will not be counted for apportionment purposes next year. Those states that have endorsed regional medical student delegates or resident sectional delegates should be aware that these delegates are not reflected in the figures that appear in the constituent society apportionment table, but rather appear in separate tables. Regional medical student delegates and resident sectional delegates will be seated with their endorsing societies when meetings take place in person. You should note, however, that student and resident alternate delegates serving temporarily will be seated in the 2 space designated for the student or resident endorsed by your society even though they are likely to have been endorsed by another society; please be sure your delegation is aware of this situation. States are encouraged to include the students and residents they have endorsed in delegation activities and communications. At this time, the format of June’s House of Delegates meeting has not been determined, as the pandemic is ongoing. Nevertheless, the credentialing process for that meeting will begin next month. Under AMA bylaws, delegates and alternate delegates must be certified before each meeting. Please ensure that your delegates and alternate delegates have renewed their AMA memberships for 2021. AMA bylaws specify that all delegates (§2.0.1.1) and alternate delegates (§2.8.1) must be AMA members, and individuals who are not members will not be included on a delegation roster. You will be notified of any discrepancies. Delegation rosters can be found at https://www.ama-assn.org/house-delegates/hod- organization/delegation-certification-rosters. Questions about the delegate apportionment process or the credentialing process should be directed to Roger Brown, Director, Office of House of Delegates Affairs, at 312-464-4344 or by email to [email protected]. Attachments Constituent Society Delegate Apportionment - 2021 AMA Regular Delegates Delegates Additional Members Number of AMA Members Delegate Under Under 2020 2021 as of Delegates as of Apportionment Bylaw Bylaw Delegate Delegate 31 Dec 2019* 2020¹ 31 Dec 2020* 2021² 2.1.1.2.1 2.1.1.2.1.1³ Allocation4 Allocation Total 275,956 304 253,389 278 304 304 2 306 Alabama 3,214 4 2,698 3 4 4 0 4 Alaska 369 1 336 1 1 1 0 1 Arizona 4,746 5 4,208 5 5 5 0 5 Arkansas 2,139 3 1,873 2 3 3 0 3 California 32,179 33 29,279 30 33 33 0 33 Colorado 4,377 5 3,877 4 5 5 0 5 Connecticut 3,503 4 3,070 4 4 4 0 4 Delaware 675 1 540 1 1 1 0 1 District of Columbia 2,026 3 1,804 2 3 3 0 3 Florida 15,297 16 14,357 15 16 16 0 16 Georgia 5,351 6 5,525 6 6 6 0 6 Guam 27 1 24 1 1 1 0 1 Hawaii 1,107 2 977 1 2 2 0 2 Idaho 582 1 545 1 1 1 0 1 Illinois 11,756 12 10,795 11 12 12 0 12 Indiana 4,910 5 4,596 5 5 5 0 5 Iowa 3,287 4 3,140 4 4 4 0 4 Kansas 2,009 3 1,667 2 3 3 0 3 Kentucky 3,878 4 3,735 4 4 4 1 † 5 Louisiana 5,811 6 5,749 6 6 6 0 6 Maine 1,375 2 1,171 2 2 2 0 2 Maryland 4,722 5 4,966 5 5 5 0 5 Massachusetts 12,619 13 11,366 12 13 13 0 13 Michigan 12,629 13 11,824 12 13 13 0 13 Minnesota 4,949 5 3,761 4 5 5 0 5 Mississippi 2,465 3 2,142 3 3 3 0 3 Missouri 5,360 6 4,859 5 6 6 0 6 Montana 689 1 658 1 1 1 0 1 Nebraska 1,768 2 1,626 2 2 2 0 2 Nevada 1,611 2 1,420 2 2 2 0 2 New Hampshire 923 1 789 1 1 1 0 1 New Jersey 7,661 8 7,433 8 8 8 0 8 New Mexico 1,120 2 1,046 2 2 2 0 2 New York 21,128 22 18,221 19 22 22 0 22 North Carolina 5,503 6 4,595 5 6 6 0 6 North Dakota 793 1 628 1 1 1 0 1 Ohio 11,264 12 10,077 11 12 12 1 † 13 Oklahoma 3,664 4 3,185 4 4 4 0 4 Oregon 2,139 3 2,273 3 3 3 0 3 Pennsylvania 12,723 13 11,240 12 13 13 0 13 Puerto Rico 1,570 2 1,453 2 2 2 0 2 Rhode Island 1,023 2 892 1 2 2 0 2 South Carolina 4,464 5 3,814 4 5 5 0 5 South Dakota 1,007 2 910 1 2 2 0 2 Tennessee 4,959 5 4,380 5 5 5 0 5 Texas 19,081 20 19,900 20 20 20 0 20 Utah 1,768 2 1,533 2 2 2 0 2 Vermont 435 1 394 1 1 1 0 1 Virgin Islands 38 1 31 1 1 1 0 1 Virginia 7,309 8 6,953 7 8 8 0 8 Washington 4,276 5 3,977 4 5 5 0 5 West Virginia 1,903 2 1,765 2 2 2 0 2 Wisconsin 4,736 5 4,186 5 5 5 0 5 Wyoming 205 1 176 1 1 1 0 1 APO/FPO/Foreign 834 950 Notes: * Includes "pending members" per §2.1.1.1 of the bylaws. The apparent overall drop in 2020 is entirely due to the way pending members are counted. 1 These figures do not include delegates allocated under §2.1.1.2.1, §2.1.2.1, §2.1.2.2 or §2.5 of the bylaws. 2 The regular apportionment of delegates is one delegate for each 1000, or fraction thereof, AMA members in the state (§2.1.1 of the bylaws). This includes pending members through 2022. 3 §2.1.1.2.1.1 is commonly referred to as a freeze and will expire at the end of 2021. 4 §2.5 of the bylaws provides an additional delegate for those societies represented by the individuals elected to be speaker and vice speaker. CONSTITUENT SOCIETIES ENDORSING MEDICAL STUDENT SECTION REGIONAL DELEGATES AND ALTERNATE DELEGATES Alternate Delegates Delegates Region 1 Arizona 1 1 California 1 1 Colorado 1 Nevada 1 New Mexico 1 1 Region 2 Illinois 1 Minnesota 1 Missouri 2 Nebraska 1 Wisconsin 1 Region 3 Louisiana 2 Texas 4 2 Region 4 Alabama 1 Florida 2 2 South Carolina 2 1 Region 5 Indiana 1 Michigan 1 1 Ohio 2 West Virginia 1 Region 6 Maryland 1 1 New Jersey 1 1 Pennsylvania 1 1 Virginia 1 1 Region 7 Connecticut 1 2 Maine 1 Massachusetts 1 2 New Hampshire 1 New York 1 1 TOTAL 27 27 This table reflects information available as of January 29, 2021 and is subject to change.